Administration of RIT
The administration of RIT can appear to be complicated, and I hope this will simplify the roles of various medical professionals.
Quoting from the Zevalin website, "Coordination and timing of the entire Zevalin therapeutic regimen, including administration of Rituximab, preparation and administration of IN-111 Zevalin (the trace dose) and Y-90 Zevalin (the full dose), evaluation of gamma camera images, patient education and treatment follow-up, are essential for successful administration of the Zevalin regimen. Treatment requires the involvement of a number of health care professionals, including the medical oncologist/hematologist, the nuclear medicine physician or radiation oncologist, the oncology/hematology nurse, the nuclear medicine or radiation oncology nurse and/or technician and the nuclear pharmacist." The website goes on to say that patients should be monitored with weekly CBC's including platelet count, until levels are normal.
The Bexxar regimen is similar, with the addition of a pre-treatment for thyroid protection which is prescribed by an oncologist who refers the patient to a nuclear medicine physician or radiation oncologist. The oncologist and nuclear medicine physician or radiation oncologist are instructed to discuss the patient's eligibility for the treatment. Once treated, the nuclear medicine physician or radiation oncologist is instructed to refer the patient back to the oncologist for post-treatment follow-up (including weekly CBC's and treatment for any side effects which may arise).
If all this sounds confusing, it really isn't. Oncologists routinely refer patients who have masses for external beam radiation and so they are accustomed to coordinating treatment with other physicians. Administration of RIT simply takes a team effort, and it is no more difficult than coordinating other treatments. It's a smokescreen if anyone tells you otherwise.
Betsy